Provider Demographics
NPI:1801867056
Name:ZUCKER, GEOFFREY M (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:M
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3158
Mailing Address - Country:US
Mailing Address - Phone:413-586-8910
Mailing Address - Fax:413-584-7270
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-3158
Practice Address - Country:US
Practice Address - Phone:413-586-8910
Practice Address - Fax:413-584-7270
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA50657207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17927OtherHEALTH NEW ENGLAND
MA20-1203197OtherNORTHEAST HEALTHCARE ALLI
MA20-1203197OtherPRIVATE HEALTHCARE SYSTEM
MA20-1203197OtherUNITED HEALTHCARE
MA3244324OtherCIGNA
MA7867OtherBMC
MA20-1203197OtherGREAT-WEST
MA20-1203197OtherUNICARE/GIC
MA713571OtherCONNECTICARE
MA737819OtherTUFTS
MA20-1203197OtherNORTHEAST HEALTH DIRECT
MA3754834OtherAETNA
MA0191264Medicaid
MA20-1203197OtherPLAN VISTA
MA20-1203197OtherCONSOLIDATED
MAJ01165OtherBCBS MA
MA20-1203197OtherNORTH AMERICAN PREFERRED
MA65253OtherHARVARD PILGRIM
MA20-1203197OtherPRIVATE HEALTHCARE SYSTEM
MA3244324OtherCIGNA